Although the FDA has approved the vaccine for girls and women 9 to 26 years of age, older women may benefit too. "If you have a cervix, you need the HPV vaccine," says Stanley Gall, M.D., professor of ob-gyn and women's health and spokesman for the American College of Obstetrics and Gynecology (ACOG).

Read on to learn more about this vaccine that represents "a significant advance in women's health," according to Anne Schuchat, M.D., director of the National Center for Immunization and Respiratory Diseases.

An Often Silent STD

HPV is America's most common STD. At least 20 million Americans are currently infected with the virus, according to the Centers for Disease Control and Prevention (CDC). Far more people have been exposed to it, but their immune system fought if off without their even knowing it. The disease often doesn't have any symptoms, but its effects can range from visible genital warts to microscopic changes to the cervix, vulva, or anus that can turn cancerous over time.

There are more than 100 strains of HPV, about 40 of which affect the genitals. Types 6 and 11 cause over 90 percent of genital warts; types 16 and 18 cause about 70 percent of cervical cancers. Gardasil protects against these four strains--but only if you haven't already been infected with them.

"If you've been exposed to one of the HPV types included in the vaccine, then the vaccine won't be effective for that type," Dr. Gall says. But it can still protect you against the other three strains. If you've been in contact with all four types, "the vaccine won't help you at all." But only 0.1 percent of women ages 16 to 25 studied tested positive for all four, according to Dr. Gall.

How do you know if you've been exposed? If your Pap test has ever been abnormal, you've almost certainly been infected--but there's no way to tell by which type. Because HPV is pervasive, public health experts hope to vaccinate girls and young women before they become sexually active.

Who Should Get Immunized

The CDC recommends that girls ages 11 and 12 be routinely vaccinated, though the vaccine can be given to girls as young as 9. It also recommends that girls and women ages 13 to 26 be immunized, even if they're already sexually active. (Note: On average, U.S. women begin having sex at 17; however, Black teens are more likely to be sexually experienced and to have more sexual partners than teens of any other racial or ethnic group, according to the National Campaign to Prevent Teen Pregnancy. Go here for info on sexual activity, pregnancy, and childbearing among Black teens. Data from the CDC also indicate that African-Americans of all ages are experiencing an STD epidemic.)

Clinical trials are now being conducted to test the vaccine in women ages 27 to 55. "It's likely it will be efficacious," Dr. Gall says. For now, he thinks it's a "good idea" to ask your doctor to vaccinate you even if you're older than 26.

Other HPV vaccines are also being clinically tested in boys. Even though the risk of penile and anal cancer in men is lower than the risk of cervical cancer in women, "it makes perfectly good sense to vaccinate males," Dr. Gall says. "Because who do girls get it from? Boys. And who do [girls] give it to?"

Matters of Safety, Effectiveness--and Cost

In clinical trials, Gardasil was nearly 100 percent effective in preventing precancerous lesions and was "not risky" to pregnant women or their babies, says Dr. Gall (although if you become pregnant during the series of shots, your doctor should discontinue them until you deliver). Possible side effects of the vaccine, which consists of three injections over a six-month period, may include some pain, swelling, and soreness at the injection site (the upper arm or thigh), though less than from a tetanus shot, Dr. Gall explains.

Each shot costs $120 and is included in the federal government's Vaccines for Children program, which covers many uninsured, underinsured, and Medicaid-eligible children. It's unclear whether women will need a booster shot later.

By the way: Even if you do get the HPV vaccine, says Dr. Schuchat, you should continue to get Pap tests, "as a safeguard." For one thing, the vaccine does not protect against all strains of HPV, which means it is still possible to get cervical cancer, although the risk is dramatically lower. If you've already been exposed to HPV and have precancerous changes such as dysplasia, there are many very effective treatments that can head off cervical cancer. The vaccine, however, will not cure those cells.

Are you interested in getting the HPV vaccine, or having your daughter vaccinated? Have you ever been diagnosed with HPV or a precancerous cervical condition? Share your concerns in the comments section below.

Hilary Beard is a Philadelphia-based writer

Published on: 07/25/2006

CDC Fact Sheet: Genital HPV Infection  
CDC STD Surveillance Report  
Medline Plus: Cervical Cancer (resources)  
WebMD: Cervical Cancer Vaccine Q&A  






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